Assessing Patient Symptoms Due to Nasal Septal Perforation: Development and Validation of the NOSE-Perf Scale

2021 ◽  
pp. 019459982199201
Author(s):  
Cullen M. Taylor ◽  
Stephen F. Bansberg ◽  
Michael J. Marino
Keyword(s):  
Nasal Obstruction ◽  
Discriminant Validity ◽  
Assessment Tool ◽  
Tertiary Care ◽  
Control Group ◽  
Septal Perforation ◽  
Specific Symptom ◽  
Nose Scale ◽  
Nasal Septal Perforation ◽  
Patient Reported

Objective Reporting patient symptoms due to nasal septal perforation (NSP) has been hindered by the lack of a validated disease-specific symptom score. The purpose of this study was to develop and validate an instrument for assessing patient-reported symptoms related to NSP. Study Design Validation study. Setting A tertiary care center. Methods The Nasal Obstruction Symptom Evaluation (NOSE) scale was used as an initial construct to which 7 nonobstruction questions were added to measure septal perforation symptoms. The proposed NOSE-Perf instrument was distributed to consecutive patients evaluated for NSP, those with nasal obstruction without NSP, and a control group without rhinologic complaints. Questionnaires were redistributed to the subgroup with NSP prior to treatment of the perforation. Results The study instrument was completed by 31 patients with NSP, 17 with only nasal obstruction, and 22 without rhinologic complaint. Internal consistency was high throughout the entire instrument (Cronbach α = 0.935; 95% CI, 0.905-0.954). Test-retest reliability was demonstrated by very strong correlation between questionnaires completed by the same patient at least 1 week apart ( r = 0.898, P < .001). Discriminant validity was confirmed via a receiver operating characteristic ( P < .001, area under the curve = 0.700). The NOSE-Perf scale was able to distinguish among all 3 study groups ( P < .001) and between NSP and nasal obstruction ( P = .024). When used alone, the NOSE scale could not discriminate between NSP and nasal obstruction ( P = .545). Conclusions The NOSE-Perf scale is a validated and reliable clinical assessment tool that can be applied to adult patients with NSP.

Application of a Computer Vision Tool for Automated Glottic Tracking to Vocal Fold Paralysis Patients

2021 ◽  
pp. 019459982198960
Author(s):  
Tiffany V. Wang ◽  
Nat Adamian ◽  
Phillip C. Song ◽  
Ramon A. Franco ◽  
Molly N. Huston ◽  
...  
Keyword(s):  
Vocal Fold ◽  
Assessment Tool ◽  
Medical Center ◽  
Characteristic Curve ◽  
Academic Medical Center ◽  
Vocal Fold Paralysis ◽  
Control Group ◽  
Large Patient ◽  
Patient Reported ◽  
Before And After

Objectives (1) Demonstrate true vocal fold (TVF) tracking software (AGATI [Automated Glottic Action Tracking by artificial Intelligence]) as a quantitative assessment of unilateral vocal fold paralysis (UVFP) in a large patient cohort. (2) Correlate patient-reported metrics with AGATI measurements of TVF anterior glottic angles, before and after procedural intervention. Study Design Retrospective cohort study. Setting Academic medical center. Methods AGATI was used to analyze videolaryngoscopy from healthy adults (n = 72) and patients with UVFP (n = 70). Minimum, 3rd percentile, 97th percentile, and maximum anterior glottic angles (AGAs) were computed for each patient. In patients with UVFP, patient-reported outcomes (Voice Handicap Index 10, Dyspnea Index, and Eating Assessment Tool 10) were assessed, before and after procedural intervention (injection or medialization laryngoplasty). A receiver operating characteristic curve for the logistic fit of paralysis vs control group was used to determine AGA cutoff values for defining UVFP. Results Mean (SD) 3rd percentile AGA (in degrees) was 2.67 (3.21) in control and 5.64 (5.42) in patients with UVFP ( P < .001); mean (SD) 97th percentile AGA was 57.08 (11.14) in control and 42.59 (12.37) in patients with UVFP ( P < .001). For patients with UVFP who underwent procedural intervention, the mean 97th percentile AGA decreased by 5 degrees from pre- to postprocedure ( P = .026). The difference between the 97th and 3rd percentile AGA predicted UVFP with 77% sensitivity and 92% specificity ( P < .0001). There was no correlation between AGA measurements and patient-reported outcome scores. Conclusions AGATI demonstrated a difference in AGA measurements between paralysis and control patients. AGATI can predict UVFP with 77% sensitivity and 92% specificity.

scholarly journals Validity and Internal Consistency of the Preschool-FLAT, a New Tool for the Assessment of Food Literacy in Young Children from the Training-To-Health Project

2020 ◽  
Vol 17 (8) ◽  
pp. 2759
Author(s):  
Garden Tabacchi ◽  
Giuseppe Battaglia ◽  
Giuseppe Messina ◽  
Antonio Paoli ◽  
Antonio Palma ◽  
...  
Keyword(s):  
Internal Consistency ◽  
Content Validity ◽  
Structural Equation ◽  
Discriminant Validity ◽  
Assessment Tool ◽  
Intervention Group ◽  
Equation Modeling ◽  
Control Group ◽  
Food Literacy ◽  
Health Project

Background: The importance of assessing “food literacy” since youth has been highlighted and, to this purpose, valid and consistent instruments are needed. This study aimed to assess the validity and internal consistency of the preschool-FLAT (Food Literacy Assessment Tool). Methods. 505 children from 21 kindergartens, recruited within the Training-to-Health Project in Palermo (Italy), underwent oral sessions and activities on food-related aspects. Their knowledge/skills were recorded in the preschool-FLAT. The following scale measures were assessed: Content validity; internal consistency (Chronbach’s alpha coefficients); construct validity (Structural Equation Modeling—SEM); discriminant validity (intervention subgroup of 100 children vs. control group of 27 children). Results. Acceptable content validity of a 16-items scale and overall adequate internal consistency were revealed: Content validity index (CVI) 0.94, content validity ratio (CVR) 0.88, Chronbach’s alpha 0.76. The SEM revealed a 4-factor model fitting the data well (comparative fit index 0.939, root mean square error of approximation 0.033). Discriminant validity was good (intervention group scoring higher than control, p < 0.001, unpaired Student’s t-test). Conclusion. The preschool-FLAT revealed good psychometric properties, adequate validity and internal consistency. This is the only instrument in the literature specifically targeted to 3–6 years old children that could be effectively used to assess food literacy.

Cartilage Sparing Septal Perforation Repair using Rotation Flaps and a Collagen Interposition Graft: A Case Series

2020 ◽  
pp. 000348942097059
Author(s):  
Benjamin G. Hunter
Keyword(s):  
Nasal Obstruction ◽  
Surgical Repair ◽  
Case Series ◽  
Collagen Matrix ◽  
Septal Perforation ◽  
Surgical Success ◽  
Interposition Graft ◽  
Patient Reported ◽  
Septal Perforations ◽  
Porcine Collagen

Objective: Septal Perforations may be asymptomatic or can cause significant problems including nasal obstruction, crusting, bleeding, whistling and in severe cases a change in nasal shape and even pain. Method: The author would like to present a single surgeon case series of septal perforation repairs, managed using an endo-nasal technique, with no external scars. There were 54 consecutive cases between 2011 and 2017. The repair was carried out using mucosal rotation flaps with an interposition graft of porcine collagen matrix. Patients were grouped according to the size of the perforation as measured at the time of the surgery. The patients were then clinically followed up for 1 year, and the recorded outcome measures were: the success of the surgical repair and the patient reported symptoms. Results: Surgical success was 70% up to 1 cm diameter, 77% from 1 to 2 cm and 82% in perforations from 2 to 3 cm in diameter. No perforation over 3 cm in diameter was successfully closed. Patients were rendered asymptomatic even if the perforation was not closed in between 81% and 91% of patients up to perforations 3 cm in size. Over 3 cm in size 50% of patients reported being asymptomatic. Conclusions: This technique is an effective and low morbidity option for patients with small to medium sized septal perforations. For perforations over 3 cm in diameter other options may be more suitable.

The results of septal button insertion in the management of nasal septal perforation

1999 ◽  
Vol 113 (9) ◽  
pp. 823-824 ◽  
Author(s):  
Üstün Osma ◽  
Sebahattin Cüreoǧlu ◽  
Nursel Akbulut ◽  
Faruk Meriç ◽  
Ismail Topçu
Keyword(s):  
Nasal Obstruction ◽  
Septal Perforation ◽  
Nasal Septal Perforation

AbstractNasal septal perforation may present with various symptoms. Perforations may be surgically closed or managed by obturation, inserting a prosthesis. We used a silicon septal button in the management of nasal septal perforation. In the follow-up period, although the insertion of the nasal septal button alleviated epistaxis, whistling during inspiration, and nasal obstruction, it could not control the production of crusting around the margin of the button.

COMPARATIVE STUDY ON IMPROVEMENT OF NASAL SYMPTOMS FOLLOWING SEPTOPLASTY WITH PARTIAL INFERIOR TURBINECTOMY VS SEPTOPLASTY ALONE IN ADULTS WITH DEVIATED NASAL SEPTUM

2021 ◽  
pp. 62-65
Author(s):  
Subhadeep Chowdhury ◽  
Tithi Debnath ◽  
Sweta Verma
Keyword(s):  
Comparative Study ◽  
Nasal Obstruction ◽  
Nasal Septum ◽  
Tertiary Care ◽  
Inferior Turbinate ◽  
Deviated Nasal Septum ◽  
Nose Scale ◽  
Nasal Symptoms ◽  
Group A ◽  
Group B

BACKGROUND: Nasal obstruction is a common presenting symptom which otolaryngologists encounter in daily clinical practice. One of the most common cause of nasal obstruction is deviated nasal septum(DNS). DNS to one side is associated with overgrowth of inferior turbinate on the contralateral side. Septoplasty alone or septoplasty with inferior turbinate reduction is the mode of treatment but that depends upon the decision of the operative surgeon. In this study we aim to collect data and come to a conclusion as to which surgery is benecial for the patients. AIMS AND OBJECTIVES: (1) To compare the symptomatic improvement of nasal symptoms following septoplasty with partial inferior turbinectomy versus septoplasty alone by NOSE Scale. (2) To corroborate the subjective ndings of NOSE Scale by rhinomanometry and nasal endoscopy. METHODOLOGY: A prospective and comparative study was done on 60 patients over a period of 1 year in a tertiary care centre. Patients were alternatively divided into two surgical groups Group A- septoplasty with partial inferior turbinectomy and Group B- septoplasty alone. Nasal Obstruction Symptom Evaluation(NOSE) was used for subjective evaluation of nasal symptoms. Rhinomanometry was used as a tool for objective evaluation of symptoms. Data was analysed using tables, graph and percentage and test of signicance. Post operative improvement RESULTS: following both group A septoplasty with partial inferior turbinectomy and group B Septoplasty alone was signicant at post op 1,3 and 6 months respectively. When both groups were compared those undergoing partial inferior turbinectomy with septoplasty had highly signicant results by NOSE scale as well as rhinomanometry and endoscopy. This study showed tha CONCLUSION: t hypertrophied turbinate need to be addressed in chronic cases of nasal obstruction with deviated nasal symptom with contralateral turbinate hypertrophy. Thus we can conclude that partial inferior turbinectomy should be done in addition to septoplasty as it is a highly effective modality for treatment of nasal obstruction in patients of nasal obstruction in patients with deviated nasal septum.

Validation of the Nasal Obstruction Symptom Evaluation (NOSE) Scale for Greek Patients

2014 ◽  
Vol 151 (5) ◽  
pp. 819-823 ◽  
Author(s):  
Vasileios A. Lachanas ◽  
Stergiani Tsiouvaka ◽  
Malamati Tsea ◽  
Jiannis K. Hajiioannou ◽  
Charalampos E. Skoulakis
Keyword(s):  
Nasal Obstruction ◽  
Internal Consistency ◽  
Control Group ◽  
Cronbach’S Alpha ◽  
Altman Plot ◽  
Bland Altman Plot ◽  
Tertiary Referral Center ◽  
Cronbach's Alpha ◽  
Nose Scale ◽  
Symptom Evaluation

Objective Nasal Obstruction Symptom Evaluation (NOSE) scale is a validated disease-specific questionnaire for the assessment of Nasal Obstruction (NO). The aim of this study was to validate the Greek-NOSE questionnaire. Study Design Prospective instrument validation study. Setting Tertiary referral center. Subjects and Methods NOSE questionnaire was translated into Greek and then translated back into English. A prospective study was conducted on adult patients with NO due to septal deviation (SD). Test-retest evaluation of SD patients was carried out. Internal consistency was assessed with Cronbach’s alpha test and test-retest reliability with Pearson’s test (correlation), kappa (reproducibility), and Bland-Altman plot (extent of agreement). Validity was assessed by comparing scores of a control group of volunteers without NO to preoperative scores of SD patients undergoing septoplasty with Mann-Whitney test. Responsiveness was assessed by comparing preoperative to 3 months postoperative scores of SD patients with paired t test and evaluating the magnitude of surgery effect. Results Test-retest evaluation was accepted on 109 patients. The Greek-NOSE had good internal consistency (Cronbach’s alpha 0.74 for test and 0.76 for retest). All its items were significantly correlated between test and retest evaluation. NOSE showed high reproducibility (mean kappa: 0.75), and almost all differences in Bland-Altman plot were between agreement thresholds. Controls (123 volunteers) had significant lower score. Postoperative scores were significantly lower than preoperative, and magnitude of surgery effect was high, both indicating good responsiveness. Conclusion The Greek-NOSE questionnaire is a valid instrument with satisfactory internal consistency, reliability, reproducibility, validity, and responsiveness.

scholarly journals Remote diagnosis of surgical-site infection using a mobile digital intervention: a randomised controlled trial in emergency surgery patients

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Kenneth A. McLean ◽  
Katie E. Mountain ◽  
Catherine A. Shaw ◽  
Thomas M. Drake ◽  
Riinu Pius ◽  
...  
Keyword(s):  
Abdominal Surgery ◽  
Assessment Tool ◽  
Tertiary Care ◽  
Routine Care ◽  
Randomised Control Trial ◽  
Wound Assessment ◽  
Significant Difference ◽  
Patient Reported ◽  
Time To Diagnosis ◽  
Emergency Abdominal Surgery

AbstractSurgical site infections (SSI) cause substantial morbidity and pose a burden to acute healthcare services after surgery. We aimed to investigate whether a smartphone-delivered wound assessment tool can expedite diagnosis and treatment of SSI after emergency abdominal surgery. This single-blinded randomised control trial (NCT02704897) enroled adult emergency abdominal surgery patients in two tertiary care hospitals. Patients were randomised (1:1) to routine postoperative care or additional access to a smartphone-delivered wound assessment tool for 30-days postoperatively. Patient-reported SSI symptoms and wound photographs were requested on postoperative days 3, 7, and 15. The primary outcome was time-to-diagnosis of SSI (Centers for Disease Control definition). 492 patients were randomised (smartphone intervention: 223; routine care: 269). There was no significant difference in the 30-day SSI rate between trial arms: 21 (9.4%) in smartphone vs 20 (7.4%, p = 0.513) in routine care. Among the smartphone group, 32.3% (n = 72) did not utilise the tool. There was no significant difference in time-to-diagnosis of SSI for patients receiving the intervention (−2.5 days, 95% CI: −6.6−1.6, p = 0.225). However, patients in the smartphone group had 3.7-times higher odds of diagnosis within 7 postoperative days (95% CI: 1.02−13.51, p = 0.043). The smartphone group had significantly reduced community care attendance (OR: 0.57, 95% CI: 0.34−0.94, p = 0.030), similar hospital attendance (OR: 0.76, 95% CI: 0.28−1.96, p = 0.577), and significantly better experiences in accessing care (OR: 2.02, 95% CI: 1.17−3.53, p = 0.013). Smartphone-delivered wound follow-up is feasible following emergency abdominal surgery. This can facilitate triage to the appropriate level of assessment required, allowing earlier postoperative diagnosis of SSI.

Porcine Tracheal Mucosa-Derived Decellularized Patch to Prevent Septal Perforation in a Rabbit Model

2020 ◽  
pp. 194589242096197
Author(s):  
So Jeong Kim ◽  
Soo Yeon Jung ◽  
Min Ji Lee ◽  
Jung Ho Bae ◽  
Han Su Kim
Keyword(s):  
Rabbit Model ◽  
Cartilage Regeneration ◽  
Control Group ◽  
Septal Perforation ◽  
Tracheal Mucosa ◽  
Mucosal Regeneration ◽  
Nasal Cartilage ◽  
Bilateral Group ◽  
Nasal Septal Perforation ◽  
Septal Perforations

Background Nasal septal perforation is caused by bilateral septal mucosal injuries resulting from nasal trauma and septal surgeries. Previous studies have reported that biocompatible materials may be effective for repairing nasal septal perforations. However, they were primarily used for treatment; no study has investigated their use for prevention of nasal septal perforation. Objective To determine whether porcine tracheal mucosa-derived decellularized patch can prevent the progression of nasal mucosa injuries to septal perforations. Methods Bilateral nasal septal mucosal defects were surgically induced in 36 rabbits. Silastic sheets were applied bilaterally in all rabbits, and decellularized mucosal patch was applied unilaterally (n = 12) or bilaterally (n = 12) at the defect site in the respective experimental groups. Between 1 and 8 weeks postoperatively, the animals were sacrificed, and their nasal septa were completely removed. The excised septa were examined macroscopically and microscopically (histopathological examinations). Moreover, glycosaminoglycan (GAG) estimations of the septa were performed to evaluate mucosal regeneration and mechanical properties. Results Septal perforations occurred in 5 animals in the control group (5/12; 42%), 1 in the unilateral group (1/12; 9%), and in none in the bilateral group. Compared with the control group, the experimental groups showed significantly different mucosal and cartilage regeneration. Conclusion Decellularized porcine tracheal mucosa can prevent mucosal defects from progressing to septal perforation, promote the repair of mucosal defects, and protect the nasal cartilage.

scholarly journals Association Between Nasal Obstruction Symptoms and Anxiety

2020 ◽  
Vol 99 (7) ◽  
pp. 448-452 ◽  
Author(s):  
Özlem Akkoca ◽  
Haldun Oğuz ◽  
Ceren Ersöz Ünlü ◽  
Emine Aydın ◽  
Kadir Ozdel ◽  
...  
Keyword(s):  
Nasal Obstruction ◽  
The Body ◽  
Control Group ◽  
Nasal Resistance ◽  
Resistance Level ◽  
Nose Scale ◽  
Significant Difference ◽  
Anxiety Levels ◽  
Nasal Pathology ◽  
And Control

Aim: The aim of this study was to determine the correlation between nasal function assessment and anxiety scales. Methods: A total of 120 patients with the complaint of nasal obstruction were classified as nasal septum deviation group (DNS) and no nasal pathology group (NON). A control group was formed of 57 healthy participants. Nasal obstruction severity was assessed using the Nasal Obstruction Symptom Evaluation (NOSE) scale, nasal resistance level with rhinomanometry and anxiety levels with the Agoraphobic Cognitions Questionnaire (ACQ), and the Body Sensations Questionnaire (BSQ). Results: There was a statistically significant difference between both the DNS and the NON groups and control group in terms of NOSE scale, ACQ, and BSQ ( P < .001). The total nasal resistance values were higher in the DNS group compared to both the NON and control groups ( P < .001), although the difference between the NON group and control group was not statistically significant. Conclusion: The results of this study showed that patients with nasal breathing complaints, but no organic pathology, had the same level of nasal obstruction symptoms as patients with nasal septal deviations. Anxiety levels are elevated in patients with symptoms of nasal obstruction, even when there is lack of organic nasal pathology.

scholarly journals Introducing Nasal Obstruction Symptom Evaluation (NOSE) scale in clinical practice in Serbia: Validation and cross-cultural adaptation

2020 ◽  
Vol 77 (7) ◽  
pp. 704-709 ◽  
Author(s):  
Natasa Janovic ◽  
Gorica Maric ◽  
Marija Dusanovic ◽  
Aleksa Janovic ◽  
Tatjana Pekmezovic ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Nasal Obstruction ◽  
High Sensitivity ◽  
Control Group ◽  
Study Group ◽  
Good Reliability ◽  
Nose Scale ◽  
Symptom Evaluation ◽  
Significant Difference ◽  
Serbian Version

Background/Aim. The Nasal Obstruction Symptom Evaluation (NOSE) scale is widely used in clinical practice for assessment of quality of life in patients with nasal obstruction. It has been validated in several countries up to date. The aim of this study was to validate and crossculturally adapt the NOSE scale for Serbian population. Methods. The Serbian version of the NOSE scale (NOSEs) was prepared through forward and backward translation, committee review, and pretesting. Validation process was carried out on 50 patients diagnosed with the nasal septal deviation (the study group) and 50 ear, nose and throat (ENT) patients with other non-rhinological diagnosis (the control group). Results. The NOSE-s instrument demonstrated good reliability (Cronbach ? coefficient 0.81). Stability and reliability of the NOSE-s questionnaire were confirmed by test-retest procedure showing no statistically significant difference in obtained responses (Goodman- Kruskal gamma coefficient 0.83). Item and total scores were significantly higher in the study group than in the control group indicating the very good inter-group discrimination (p < 0.001). Inter-item and item-total correlations were similar to the original NOSE instrument. Three months after septoplasty, a mean NOSE-s score in patients was 19.2 ? 12.8. Calculated standardized response mean of 1.7 showed high sensitivity to change. Conclusion. The Serbian version of the NOSE scale is simple, valid and reliable instrument for estimating the nasal obstruction. Therefore, it can be recommended for application in rhinological practice and research in Serbian speaking population.

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